|
 Originally a Medicaid program that provided health insurance for
children in low-income families in the state, KidCare was expanded
by former Gov. Rod Blagojevich to allow any child into the program
and was renamed All Kids. The non-Medicaid part of All Kids --
called expanded All Kids -- allows parents who do not qualify for
Medicaid to buy lower premium health insurance for their children
from the state.
Medicaid is a joint state-federal health insurance program primarily
for pregnant women and children under 6 with families who earn less
than 133 percent of the federal poverty level. Children 6-18 with
family incomes less than 100 percent of the federal poverty level
also qualify for Medicaid. The state and federal governments share
the cost of Medicaid. However, the state receives no federal match
for children covered under expanded All Kids.
The heart of the audit took issue with expanded All Kids.
The audit recommended that state residents enrolling in All Kids
provide proof of a month's worth of income, instead of the current
requirement of only one pay stub. This would, for example, prevent
hourly earners from using an unusually small check as a way to get
cheap or free insurance for their children.
Changing the rule isn't as easy as that, according to a presentation
Thursday to lawmakers on the Legislative Audit Commission by the
Department of Healthcare and Family Services and the Department of
Human Services. The change would require the federal government to
sign off, something neither department has arranged yet, according
to the presentation.
Also of concern in the audit and a previous audit of the state's
Medicaid program is a situation where a number of people are
re-enrolled by simply doing nothing. Every year the state sends out
forms to All Kids participants, asking them to note any changes in
their eligibility and mail it back. If those in the program who make
less than 200 percent of the federal poverty level don't send it
back, even if their eligibility has changed, they are re-enrolled.
These "passive redeterminations" need to be addressed, according to
state Sen. Dale Righter. Of the 71,665 people in expanded All Kids
at the time of the audit, about 75 percent of them, the vast
majority undocumented immigrants, were eligible for passive
enrollment.
"It's one of the reasons you're seeing skyrocketing numbers in the
Medicaid program," he said.
Thursday's presentation addressed this briefly, showing it is
something the departments are aware of and working on, though it
gave no definite solution.
A heavy reliance on the state's strained coffers makes changes to
All Kids a necessity, Righter said.
[to top of second column] |
Democratic state Sen. Dave Koehler agrees that changes need to be
made to All Kids and Medicaid, but he is wary about making people
jump through too many hoops.
"Where there's legitimate fraud, we need to put safeguards in
system. But what I'm not interested in doing is hassling people so
we discourage (eligible) people from being involved in the program,"
the Peoria Democrat said.
Gov. Pat Quinn's office, which ultimately is in charge of both the
Department of Healthcare and Family Services and the Department of
Human Services, said in a Nov. 29 Illinois Statehouse News article
that it is not interested in restraining eligibility for the
non-Medicaid section of All Kids.
Both Koehler and Righter are on a special committee created by the
Legislature to suggest Medicaid reforms. The committee has met twice
in the past two weeks, in Springfield and Chicago, to address the
issue.
Righter, who is also a member of the audit commission, said
Thursday's meeting was coincidental, though "obviously it is timely
in terms of the current discussion."
Tightening enrollment requirements is low-hanging fruit, Righter
added, and it doesn't need extensive expert testimony at the reform
committee hearings. Instead, Righter said to look for topics like
managed care to come up at the Tuesday meeting of the reform
committee.
Whatever recommendations the committee delivers in January, the real
measure of success will be whether they can move from ideas to law.
"We'll see whether or not that's a serious pitch to get something
done," Righter said.
[Illinois
Statehouse News; By ANDREW THOMASON]
 |
